Saturday, July 23, 2011

Health and Fitness

The recent walking project I did was aimed at teaching children about choices they can make to improve their health, including nutrition, exercise and the effects of alcohol and smoking.The program was designed to address the trends behind the leading causes of death in Armenia – heart disease and cancer - and other areas representing risk factors for disease (see a summary here ).

One volunteer who was not on the walk commented “Make sure you tell all the kids that after they work in the fields all day that they need to exercise!” and that highlights a seeming contradiction in Armenian life.Many people are active here (I used to get exhausted seeing my Solak host mother do all of her daily chores, rural children often miss school when there are crops to harvest and I always see kids running around playing soccer) yet many are overweight (high Body Mass Index is one of the leading risk factors noted). While many of the men tend to be very thin, many others and many women are what I might call “husky”. And being called fat here is not meant as an insult – it is intended as a compliment that you appear well fed.

Over the past year, I have witnessed some of the reasons for and have heard about common beliefs that contribute to the weight issue as well as other health problems.

If there were an Armenian food pyramid, sugar would have a place on it.A substantial portion of every grocery store I have been in is devoted to candy and cookies that you buy by the kilo. Every home I have been in has had a candy dish available to dip into any time.In warmer weather, ice cream is a staple for all ages.I saw a mother break up a candy bar and give pieces to her three children – the five year old son, the three year old daughter and another son in his crib.

Another spot on the food pyramid would be reserved for salt.While Armenian food is not typically spicy, if something isn’t sweet here it’s salty.I always hear stories of volunteers who cook with their host mothers and getting into a friendly battle about how much salt is needed in a dish.There are no salt shakers on tables here – there are open dishes that you stick your fingers into and grab as much as you want (whether this common bowl and less hand-washing leads to other health issues is another matter entirely).

Most kitchens here have what I call the “bucket o’ fat” that is used for cooking.Sunflower oil is also popular (and relatively healthy) but I have no idea what the other stuff is.

Many girls and women don’t drink water here believing it makes them fat [I have heard another theory that it is because there is some shame involved in using a restroom other than the one at home, but more often it is the weight issue.]It may be partially true, but I suppose that would relate to the high level of salt in the bodies here. This seems to belie the "fat-as-a-compliment" issue, but any striving for Western style norms could be accompanied by other health problems.

A typical grocery store

And then there are the things that can get you chastised.

Lots of things cause you to be “cold”.If you walk around without socks (and god forbid, without shoes/slippers) you will get sick. Eating ice cream can sometimes cause a cold, as can wearing light clothing or drinking cold water.

If a breeze hits you in an enclosed area it can automatically cause a variety of health problems – pain in your back, an earache or the overall "cold".As a result, opening a marshutni window to alleviate the stifling summer heat is often greeted with horrified looks and dagger eyes if you do not close it.If a window is opened in a hot room, the door is usually closed to avoid the wind.

If you sit on a concrete wall, you will become infertile.

I have also heard that petting a cat can cure a headache. Other cures I have heard of are putting cold vodka on a burn and using matsun (Armenian yogurt) to cure almost anything. I have also heard that by not cutting the hair on my head I can slow the growth of other hair on my body and that my hair is actually growing back the longer I live here.On that last point, there may be something to that and, if so, this place can become the tourist destination they want it to be.

But Armenia doesn’t have a lock on these types of beliefs.Watermelon is a very popular snack here and people eat the seeds as a matter of course.To lessen my “otherness” here I have started to do so as well when I am a guest in someone’s house and, despite what the nuns told me, no watermelons have grown in my stomach (yet).

Maybe because of distrust of doctors (see my last post about their qualifications) or the lack of money, a lot of people don’t seek medical care [I have been told not to go to the hospital in Gyumri unless I am on death’s door – I should take a taxi to Yerevan in case of an emergency].Instead, people self-medicate and, luckily, it is very easy to do so.When my mother was visiting recently, she needed a refill of antibiotics she had been prescribed in the US.I was afraid I would need to find a reputable doctor and get a prescription but instead I learned that I just needed to know what it was called – I was told the Russian name for her medication and I was able to go into a pharmacy and buy it.Many houses have a supply of antibiotics around, some of which are injectable. A fellow volunteer who came down with a cold while we were in training was chased around by her syringe-wielding host mother who was trying to help her get well.

We are lucky in that we have two doctors in Yerevan that we can contact around the clock, we have medication provided to us and medical kits given to us the day we arrive.If there are any concerns, we can go to see the doctors to ensure that everything is taken care of.And we all have socks and slippers, just in case.

While I do see a lot of people exercising in some way (walking around the square, doing house chores or gardening, playing soccer and sometimes running) gyms here are pretty rare.In New York, they rival Starbucks for ubiquity - in the ten minute walk from my New York apartment to the New York Sports Club branch I like, I pass another of the same chain and three others are reachable with a short walk while there are other operators in close proximity also.

In Yerevan, I have heard of a Gold’s Gym that charges 10,000 dram for a day pass (about $26) so it must cater to the expat community.Another near the hostel where I often stay is only 1000 dram for a day pass but it was empty the day I went, except for the fellow volunteer who told me about it.The hostel operators had never heard about it.

In Gyumri, in the first four months I was here I saw only two – one that is for women only and seemed to be open only on weekends, and one that was run by a couple of Russians and didn’t seem to have much equipment.

Then I learned of one that is only a few minutes’ walk from my apartment and that all the locals seem to know about (luckily we discussed exercise in our conversation club one week or I might still not have heard about it).It is rustic to say the least, but it is open six days a week and only costs 3000 dram per month (that translates to about $8 compared to the $80 or so I paid in New York).I am now the envy of some other volunteers who have not found one at their sites, although one guy has one that costs 1000 dram per month so I think he wins.

As with everything else, the gym experience here is different than I am used to.Not surprisingly, I have never seem a woman in mine except for the two who clean while the other that I mentioned above is for women only.[There is also a public pool in town that is open to everyone most days but there are a few hours set aside every Sunday when no men are allowed].

The place is in the basement under the chess school.There is a changing room but no lockers (you are told to keep your money, phone and watch with you or at the owner’s desk or not bring them).There is a shower but you pay extra if you want to use it.

Most of the equipment is old, kinda rusty but mostly functional.There is no aerobic equipment except for what I guess is a treadmill and I have never seen anyone use it. There are 1980’s vintage posters adorning the walls for inspiration including pre-Hollywood, pre-Governor, pre-child-out-of-wedlock Arnold.

As for entertainment, there is an old stereo system and there is usually an iPod plugged into it.Many of the people in this country seem to like listening to the same song numerous times in a row and the people there are no exception.The music selection doesn’t vary much so I have lost count of how many times I have heard “Eye of the Tiger”, “I Got the Power” and a few gems by Rammstein

The guys tend to arrive and leave in groups.While I often see people with a “workout buddy” at home, here it is more common to see four or six together.Most are late teens to mid-twenties (it can be hard to guess ages here) but there are quite a few young kids and several older guys I see frequently.

The young kids seem to be very interested in what others do and may stand and watch.Every once in a while arm-wrestling contests will crop up and everyone except me seems to stop to observe.A couple of weeks back, I was challenged to one of these.Arm-wrestling was never my forte and the other guy is about half my age and in much better shape than me.As a result, everyone got to witness me getting crushed inside of a second.While I could have felt humiliated I didn’t - I smiled, shrugged, shook his hand and went back to my workout.I suppose that after being there several months it is a sign that I am continuing to assimilate. But next time….

I continue to walk everywhere and wish that the roads near me were more suited for bicycling. As with everything else, I make do with what I have here.

And the most encouraging thing that I have heard this year was the reaction from many of the adults we encountered along the walk. They may have their bad habits but when we explained that we were trying to teach good ones to their kids, they really seemed to appreciate it. So, let the kids stare at me and my workout. If they keep exercising, its worth it.

What This is About

These are my observations of living in Armenia during my service with the Peace Corps. The contents of this website are mine personally and do not reflect any position of the U.S. Government or the Peace Corps.